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Home My WebLink About0336 WAKEBY ROAD - Health 37Wai-' keby Zonci Marsknns Mills / A = 028 014 004 may_::.._-s..::! • .. Y No.�I.............. ' Fps... ...................... THE COMMONWEALTH OF MASSACHUSETTS BOAR%OF' HEALTH ..... .....OF.. .... - ..................................... Applirattion for DiopuiFal Workii Tomitrnrtiun Frrutit Application is hereby made for a Permit to Construct ( Vr`01r Repair ( ) an Individual Sewage Disposal System at: ................___.... :I s dr ......................... ........................................ .. = Location• ess - or Lot No. ......................__..Q.P..:MA.l:T'e2.........�-...v v1 ................. ..........----............................. ........._._.... �. ............••--••----••-•---... �O,w�n Address Installer Address /r. 44� Type of Building Size Lot......J_.:-k- _Sq-_fleet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria W Other fixtures ------------------------•-----•- - �j W Design Flow................... 5��__ _______...gallons per person per day. Total daily flow......................s.._ <)......gallons. WSeptic Tank—Liquid capacity..gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width...... ....... Total Length.................... Total leaching area-.----------_-------sq. ft. ...__. Seepage Pit No.............�.__. Diameter.............. Depth below inlet.......L........ Total leaching area.... ....sq. ft. Z Other Distribution box ( ✓) Dosing tank ( ) Percolation Test Results Performed b __ _ ff.__...t........................ Date....... Test Pit No. 1................minutes per inch Depth of Test it...........__._._... Depth to ground water........................ Test Pit No. 2................minutes.per inch Depth of Test Pit.................... Depth to ground water........................ Q+' •------••------•------------••-•-••••-•••-•-•-••--•••••..............•-••-•-•----•-•-•......•-•--•--.............. ---...... ------------------------ ---------- 0 Description of Soil........................................................................................................................................................................ IL ---------------------------•-----•---•----••--••••--------------------------------•---•--•-••----•----•--------•--•-----•----------••------•-------•---------•----•-•--------•--•-...-•---•--•----•--- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------•--•-------------------------•-•--••---...-------•-•--------•-----•......_......--•--._.....•----•--•-••---•------------•-----•-------•------•---•---•---•-•-----•---•----------...-•••......._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.S 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... __.._ _- �� Application Approved Y `�_2/ Date Application Disappro cif r the following reasons-------------•-------------------•---------------------------••---------------------•---------ate-------------- --•••----•••--••-••-•---••-•.................•---------•---....-•-•-------•--------••••-••-•-----•-....•-'-••---•-----•--•-----........................-----••............----------•Date--•-•••---•--- PermitNo............'............................................. Issued....................................................... Date NO......................... Fmc.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH :'.� ..T4.1 ............. Appliration for Dispnaal Works Tnnitrnrtinn ramit Application is hereby made for a Permit to Construct (%) or Repair ( ) an Individual Sewage Disposal System at: .....--•---.....__...._t!�:�.n ,...............l- ` ._..':: .......................... .� 1-... ................. .... . Location-Address or Lot No. ----•-••---•-••--------_.... ..... -------------••----•-•- --........-------•--......-••---------------------•--•----•-•--•-•----..._.....-----............. Owner Address W G4 Installer Address f; �/- VType of Building Size Lot....--..:_I_.._Y_. .....ST-feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -----------•----------••-------- - WDesign Flow............... �_`_... .....---__gallons per person per day. Total daily flow.....................:_-�............ _____._gallons. WSeptic Tank—Liquid capacityf M—gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area_.__.r .......sq. ft. Seepage Pit No_____________ Diameter--------------- Depth below inlet......./ ........ Total leaching area.... ....sq. ft. Other Distribution box ( ✓) Dosing tank ( ) Percolation Test Results Performed by._......... ..1_...__.. ..�'. ...................... ....-�-�- ..cam _'_•.---. W Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ M ------------------------------------------•--------------•-•--------...........••--•-•----.................................................................. 0 Description of Soil........................................................................................................................................................................ x `2-fw F....---•--•-•� ` d!Z>........................................................................................................V W UNature of Repairs or Alterations—Answer when applicable............................................................................................... il -----•----------------------•----------•------•-•---•-•----•------••-------------------•------.......----•---------------------------------------------•--•--------•-------••---•-...------.........--.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Com fiance has been issued by the board of health. Signed................................................................................... 17�114i�e6l�'OjApplication Approved --- ---•-------••-•••-••-------•------•---•----•--•-•-••-•----••-------------•-•-•......•--•-•• e Date Application Disapproved for the following reasons------------------•---------•------------•--------------•---•---------------------------•----------....•--..._._ --------------------•----------------•------•-----------•------------------------•---------•--------------------•---------------•-----------------------------------------------•--------------••••-•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................�.(�...lJ f..............OF......... .�y-.!�:.rs. ?..1.-. f'�t..:.t. ............................ (Irrtifiratr of Tontplittnrr , T � CERTIFY That th In ividua�S age Disposal System constructed ( ) or Repaired ( ) by, ----- V Installer . ,,`' at--••-.....--•---•---------•.................. . _..... ............................... ------------------------- ---- has been installed in accordance wit �e provisions of T I��"_r df the State Sanitaryi des ri ed in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................................................................� � Inspector........................................ �.i-- ......- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH u i srA .U(.fJl ...........OF....... .f^ .i�.ail.. `..!.�J.LCV.._......................... No......•.................. FEE........................ rk �n nriirrn rani# Permissioni by granted----- .._...------------------------------------------•.................._.............--.. to Construct rI;kpair ( ) a� wa i osal System at No. street �"•--•-------- :' 2{ y�................ as shownZT ' n for Disposal Works Construction Permit No---- - - --------- Dated_.____._...._._...___..__.______._......_. ....................... .•--- -------------------- •••---------•-••----••-•----....-----...... Board of Health DATE--•. ............................................... FORM 1255 A. M. SULKIN, INC., BOSTON L OCA TON �, / /� / SEWAGE PERMIT NO. VILLAGE , G* A INSTALLER' N ME i ADDR.ESS 1 ®� {U I L D E ItOR 0 WN ER DATE PERMIT ISSUED ki DAT E COMPLIANCE ISSUED rra MI CERTIFICATE OF ANA{ Y i RONBLE Page: 1 Y 7��k \3 r Barnstable County Health Laborator Report Dated: 4/4/2005 �U�J Report Prepared For: Order No.: G05296 James West P 0 Box 1015 Marstons Mills, MA 02648 Laboratory ID#: 0529601-01 Description: Water-Drinking Water Sample#: 29601 Sampling Location 336 Wakeby Road Marstons Mills,MA Collected: 3/31/2005 Collected by: J.West Received: 3/31/2005 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB: Inorganics Nitrate as Nitrogen 0.40 mg/L 0.1 10 EPA 300.0 3/31/2005 LAB: Metals Copper BRL mg/L 0.1 1.3 SM 3111B 4/l/2005 Iron 0.30 mg/L 0.1 0.3 SM 3111B 4/l/2005 Sodium 10 mg/L 1.0 20 SM 3111B 4/1/2005 LAB: Microbiology Total Coliform Absent P/A 0 Absent 309 3/31/2005 LAB.; Physical Chemistry Conductance 130 umohs/cm 1 EPA 120.1 3/31/2005 pH 7.1 pH-units 0 EPA 150.1 3/31/2005 Sample has higher than average levels of Iron that may have cosmetic effects(such as tooth or skin discoloration)or aesthetic effects(such as taste,odor,or color)of the drinking water. Approved (Lab -rector) RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 , . i { M w w-�-�"ter .�.................�-...........--.. � i Ni , P AL.� t• r +r t€ t , w • . , � r•_..,-. „� ems' �' • � ' _ may - ,,..,�Ut, . , t f� to 40�A(. 647j Rix- Icy? n. 1 I 6` � `' ' i a r l , 1 t �..�,.� C � r' ,. e � ✓�' i: < r ,�! r+ ' t sue• A,rw �s., � d Sa e�` s a - r• �#^`',a�wri""'�'Via,� �';�' �� za �, t . ,. .. !1 .vw ISO 42-S lk '� x